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Defining clinically meaningful therapeutic endpoints in Eosinophilic Esophagitis

English title Defining clinically meaningful therapeutic endpoints in Eosinophilic Esophagitis
Applicant Schoepfer Alain
Number 160115
Funding scheme Project funding (special)
Research institution Centre Hospitalier Universitaire Vaudois Service de Gastro-enterologie et Hépatologie CHUV
Institution of higher education University of Lausanne - LA
Main discipline Internal Medicine
Start/End 01.05.2015 - 30.04.2018
Approved amount 429'000.00
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Keywords (9)

33CS30_148422; Swiss Inflammatory Bowel Disease Cohort Study; large nested project; large nested project; Eosinophilic esophagitis; Swiss Inflammatory Bowel Disease Cohort Study; Outcomes research; 33CS30_148422; large nested project (SIBCS)

Lay Summary (German)

Lead
Unsere Forschungsgruppe hat über die letzten Jahre Instrumente in Form von Fragebogen entwickelt mit welchen die Aktivität der eosinophilen Oesophagitis (Speiseröhrenentzündung aufgrund von sog. eosinophilen Entzündungszellen) gemessen werden kann. Mittels diesen Instrumenten kann die Erkrankungs-Aktivität auf Ebene der Symptome, der Lebensqualität, des Spiegelungsbefundes (Speiseröhrenspiegelung), sowie der Mikroskopie erfasst werden. Dieses Projekt verfolgt die folgenden Ziele: 1. Erfassung welche krankheitsbedingten Veränderungen für die Patienten und die behandelnden Aerzte wichtig sind; 2. Untersuchung des Zusammenhangs zwischen Symptomenschwere und Lebensqualität, Spiegelungsbefund, und Mikrosokopie; 3. Untersuchung der Effektivität einer neuen Behandlungsstrategie. Dieses Projekt hat das Potenzial die Zulassung von spezifischen Therapien für die eosinophile Oesophagitis zu beschleunigen.
Lay summary

Die Eosinophile Oesophagitis (EoE) wurde erstmals 1993 beschrieben und wird zunehmend häufig diagnostiziert. Aktuell leidet etwa eine Person unter 2'000 Einwohnern in der Schweiz an einer eosinophilen Oesophagitis. Betroffene Patienten leiden vor allem an Schluckbeschweren (vor allem für feste Speisen) und/oder Brustschmerzen (unabhängig oder abhängig von der Mahlzeiteneinnahme). Der Grossteil der Patienten hat Allergien (Asthma, Nahrungsmittelallergien), Männer sind 3x häufiger als Frauen von der EoE betroffen. 

Die Erkrankung kann folgendermassen behandelt werden: Schlucken von in der Speiseröhre wirksamem steroid-haltigen Sirup oder Puder (gleiches Medikament wird auch zur Asthma-Behandlung in Form eines inhalierten Sprays eingesetzt), Diäten, oder Erweiterungsbehandlungen der Speiseröhre anlässlich einer Spiegelung. Bisher existiert keine von den Behörden zugelassene Therapie für die Behandlung der EoE, unter anderen deshalb, weil bis vor kurzem keine Instrumente (Fragebogen) existierten mit welchen die Aktivität der Entzündung zuverlässig erhoben werden konnte. Unsere Forschungsgruppe hat über die letzten Jahre Instrumente entwickelt mit deren Hilfe die Erkrankungs-Aktivität auf Ebene der Symptome, der Lebensqualität, des Spiegelungsbefundes (Speiseröhrenspiegelung), sowie der Mikroskopie erfasst werden kann.  

Unser Projekt verfolgt die folgenden Ziele: 1. Erfassung welche krankheitsbedingten Veränderungen für die Patienten und die behandelnden Aerzte wichtig sind; 2. Untersuchung des Zusammenhangs zwischen Symptomenschwere und Lebensqualität, Spiegelungsbefund, und Mikrosokopie; 3. Untersuchung der Effektivität einer neuen Behandlungsstrategie mit einem entzündungshemmendem Sirup.

Dieses Projekt hat das Potenzial die Zulassung von spezifischen Therapien für die eosinophile Oesophagitis zu beschleunigen.

Direct link to Lay Summary Last update: 26.03.2015

Responsible applicant and co-applicants

Employees

Publications

Publication
Updated international consensus diagnostic criteria for eosinophilic esophagitis: Proceedings of the AGREE conference.
Dellon Evan (2018), Updated international consensus diagnostic criteria for eosinophilic esophagitis: Proceedings of the AGREE conference., in Gastroenterology , 18.
Maintenance Treatment of Eosinophilic Esophagitis With Swallowed Topical Steroids Alters Disease Course Over A 5-Year Follow-Up Period in Adult Patients
Greuter Thomas, Safroneeva Ekaterina, Bussmann Christian, Biedermann Luc, Vavricka Stephan R., Katzka David A., Schoepfer Alain M., Straumann Alex (2018), Maintenance Treatment of Eosinophilic Esophagitis With Swallowed Topical Steroids Alters Disease Course Over A 5-Year Follow-Up Period in Adult Patients, in Clinical Gastroenterology and Hepatology, S1542-3565.
Eosinophilic esophagitis: latest insights from diagnosis to therapyEosinophilic esophagitis: latest insights
Schoepfer Alain, Blanchard Carine, Dawson Heather, Lucendo Alfredo, Mauro Aurelio, Ribi Camillo, Safroneeva Ekaterina, Savarino Edoardo V., Penagini Roberto (2018), Eosinophilic esophagitis: latest insights from diagnosis to therapyEosinophilic esophagitis: latest insights, in Annals of the New York Academy of Sciences, epub.
Cohort Profile: The Swiss Eosinophilic Esophagitis Cohort Study (SEECS)
Safroneeva Ekaterina, Saner Catherine, Rossel Jean-Benoît, Golay Delphine, Pittet Valérie, Godat Sébastien, Diem Stefan, Aepli Patrick, Sawatzki Mikael, Borovicka Jan, Burgmann Konstantin, Juillerat Pascal, Netzer Peter, Sendensky Alexander, Hruz Petr, Girardin Marc, Biedermann Luc, Greuter Thomas, Vavricka Stephan, Michetti Pierre, Mueller Christoph, Straumann Alex, Schoepfer Alain M. (2018), Cohort Profile: The Swiss Eosinophilic Esophagitis Cohort Study (SEECS), in Inflammatory Intestinal Diseases, 2(3), 163-170.
Eosinophilic Esophagitis: Relationship of Subepithelial Eosinophilic Inflammation With Epithelial Histology, Endoscopy, Blood Eosinophils, and Symptoms
Schoepfer Alain M, Simko Audrey, Bussmann Christian, Safroneeva Ekaterina, Zwahlen Marcel, Greuter Thomas, Biedermann Luc, Vavricka Stephan, Godat Sébastien, Reinhard Antoine, Saner Catherine, Maye Hugo, Sempoux Christine, Brunel Christophe, Blanchard Carine, Simon Dagmar, Simon Hans-Uwe, Straumann Alex (2018), Eosinophilic Esophagitis: Relationship of Subepithelial Eosinophilic Inflammation With Epithelial Histology, Endoscopy, Blood Eosinophils, and Symptoms, in The American Journal of Gastroenterology, 113(3), 348-357.
Heterogeneity in Clinical, Endoscopic, and Histologic Outcome Measures and Placebo Response Rates in Clinical Trials of Eosinophilic Esophagitis: A Systematic Review.
Ma Chris (2018), Heterogeneity in Clinical, Endoscopic, and Histologic Outcome Measures and Placebo Response Rates in Clinical Trials of Eosinophilic Esophagitis: A Systematic Review., in Clinical Gastroenterology and Hepatology, 18.
Latest Insights on the Relationship Between Symptoms and Biologic Findings in Adults with Eosinophilic Esophagitis
Safroneeva Ekaterina, Straumann Alex, Schoepfer Alain M. (2018), Latest Insights on the Relationship Between Symptoms and Biologic Findings in Adults with Eosinophilic Esophagitis, in Gastrointestinal Endoscopy Clinics of North America, 28(1), 35-45.
Pharmacologic Treatment of Eosinophilic Esophagitis
Schoepfer Alain M., Straumann Alex, Safroneeva Ekaterina (2018), Pharmacologic Treatment of Eosinophilic Esophagitis, in Gastrointestinal Endoscopy Clinics of North America, 28(1), 77-88.
Creating a multi-center rare disease consortium – the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR)
Cheng Katherine, Gupta Sandeep K., Kantor Susanna, Kuhl Jonathan T., Aceves Seema S., Bonis Peter A., Capocelli Kelley E., Carpenter Christina, Chehade Mirna, Collins Margaret H., Dellon Evan S., Falk Gary W., Gopal-Srivastava Rashmi, Gonsalves Nirmala, Hirano Ikuo, King Eileen C., Leung John, Krischer Jeffrey P., Mukkada Vincent A., Schoepfer Alain, Spergel Jonathan M., Straumann Alex, Yang Guang-Yu, Furuta Glenn T., et al. (2017), Creating a multi-center rare disease consortium – the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR), in Translational Science of Rare Diseases, 2(3-4), 141-155.
Current concepts in eosinophilic esophagitis
Simon Dagmar, Straumann Alex, Schoepfer Alain M., Simon Hans-Uwe (2017), Current concepts in eosinophilic esophagitis, in Allergo Journal International, 26(7), 258-266.
Eosinophile Oesophagitis
Vavricka Stephan R., Safroneeva Ekaterina, Schoepfer Alain (2017), Eosinophile Oesophagitis, in Therapeutische Umschau, 74(6), 309-315.
Long-Term Treatment of Eosinophilic Esophagitis With Swallowed Topical Corticosteroids: Development and Evaluation of a Therapeutic Concept
Greuter Thomas, Bussmann Christian, Safroneeva Ekaterina, Schoepfer Alain M, Biedermann Luc, Vavricka Stephan R, Straumann Alex (2017), Long-Term Treatment of Eosinophilic Esophagitis With Swallowed Topical Corticosteroids: Development and Evaluation of a Therapeutic Concept, in The American Journal of Gastroenterology, 112(10), 1527-1535.
Discovery and characterization of a novel humanized anti-IL-15 antibody and its relevance for the treatment of refractory celiac disease and eosinophilic esophagitis
Vicari Alain P., Schoepfer Alain M., Meresse Bertrand, Goffin Laurence, Léger Olivier, Josserand Soheila, Guégan Nicolas, Yousefi Shida, Straumann Alex, Cerf-Bensussan Nadine, Simon Hans-Uwe, Chvatchko Yolande (2017), Discovery and characterization of a novel humanized anti-IL-15 antibody and its relevance for the treatment of refractory celiac disease and eosinophilic esophagitis, in mAbs, 9(6), 927-944.
Eosinophilic esophagitis: unclear roles of IgE and eosinophils
Blanchard C., Simon D., Schoepfer A., Straumann A., Simon H.-U. (2017), Eosinophilic esophagitis: unclear roles of IgE and eosinophils, in Journal of Internal Medicine, 281(5), 448-457.
Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults
Lucendo Alfredo J, Molina-Infante Javier, Arias Ángel, von Arnim Ulrike, Bredenoord Albert J, Bussmann Christian, Amil Dias Jorge, Bove Mogens, González-Cervera Jesús, Larsson Helen, Miehlke Stephan, Papadopoulou Alexandra, Rodríguez-Sánchez Joaquín, Ravelli Alberto, Ronkainen Jukka, Santander Cecilio, Schoepfer Alain M, Storr Martin A, Terreehorst Ingrid, Straumann Alex, Attwood Stephen E (2017), Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults, in United European Gastroenterology Journal, 5(3), 335-358.
Substantial Variability in Biopsy Practice Patterns Among Gastroenterologists for Suspected Eosinophilic Gastrointestinal Disorders
Dellon Evan S., Collins Margaret H., Bonis Peter A., Leung John, Capocelli Kelley E., Dohil Ranjan, Falk Gary W., Furuta Glenn T., Menard-Katcher Calies, Gupta Sandeep K., Hirano Ikuo, Hiremath Girish S., Kagalwalla Amir F., Wershil Barry K., Liacouras Chris A., Muir Amanda B., Mukkada Vincent A., Putnam Philip E., Schoepfer Alain M., Straumann Alex, Wo John M., Yang Guang-Yu, Rothenberg Marc E., Gonsalves Nirmala (2016), Substantial Variability in Biopsy Practice Patterns Among Gastroenterologists for Suspected Eosinophilic Gastrointestinal Disorders, in Clinical Gastroenterology and Hepatology, 14(12), 1842-1844.
How to measure disease activity in eosinophilic esophagitisHow to measure disease activity in EoE
Schoepfer A., Safroneeva E., Straumann A. (2016), How to measure disease activity in eosinophilic esophagitisHow to measure disease activity in EoE, in Diseases of the Esophagus, 29(8), 959-966.
Eosinophilic esophagitis: What can we learn from Crohn’s disease?
Molina-Infante Javier, Schoepfer Alain M, Lucendo Alfredo J., Dellon Evan S (2016), Eosinophilic esophagitis: What can we learn from Crohn’s disease?, in United European Gastroenterology Journal, 5(6), 762-772.
Eosinophilic esophagitis: current perspectives from diagnosis to managementReview on eosinophilic esophagitis
Moawad Fouad J., Cheng Edaire, Schoepfer Alain, Al-Haddad Sahar, Bellizzi Andrew M., Dawson Heather, El-Zimaity Hala, Guindi Maha, Penagini Roberto, Safrooneva Ekaterina, Chehade Mirna (2016), Eosinophilic esophagitis: current perspectives from diagnosis to managementReview on eosinophilic esophagitis, in Annals of the New York Academy of Sciences, 1380(1), 204-217.
Eosinophilic Esophagitis, Eosinophilic Gastroenteritis, and Eosinophilic Colitis: Common Mechanisms and Differences between East and West
Ishihara Shunji, Kinoshita Yoshikazu, Schoepfer Alain (2016), Eosinophilic Esophagitis, Eosinophilic Gastroenteritis, and Eosinophilic Colitis: Common Mechanisms and Differences between East and West, in Inflammatory Intestinal Diseases, 1(2), 63-69.
Eosinophilic Esophagitis: Impact of Latest Insights Into Pathophysiology on Therapeutic Strategies
Schoepfer Alain, Safroneeva Ekaterina, Straumann Alex (2016), Eosinophilic Esophagitis: Impact of Latest Insights Into Pathophysiology on Therapeutic Strategies, in Digestive Diseases, 34(5), 462-468.
A new eosinophilic esophagitis (EoE)-like disease without tissue eosinophilia found in EoE families
Straumann A., Blanchard C., Radonjic-Hoesli S., Bussmann Ch., Hruz P., Safroneeva E., Simon D., Schoepfer A. M., Simon H.-U. (2016), A new eosinophilic esophagitis (EoE)-like disease without tissue eosinophilia found in EoE families, in Allergy, 71(6), 889-900.
Eosinophilic esophagitis is characterized by a non-IgE-mediated food hypersensitivity
Simon D., Cianferoni A., Spergel J. M., Aceves S., Holbreich M., Venter C., Rothenberg M. E., Terreehorst I., Muraro A., Lucendo A. J., Schoepfer A., Straumann A., Simon H.-U. (2016), Eosinophilic esophagitis is characterized by a non-IgE-mediated food hypersensitivity, in Allergy, 71(5), 611-620.
Positioning of dilation in eosinophilic oesophagitisTherapy
Straumann Alex, Schoepfer Alain (2016), Positioning of dilation in eosinophilic oesophagitisTherapy, in Nature Reviews Gastroenterology & Hepatology, 13(4), 192-194.
Patient-Reported Outcomes in Eosinophilic Esophagitis and Achalasia
Schoepfer Alain, Straumann Alex, Safroneeva Ekaterina (2016), Patient-Reported Outcomes in Eosinophilic Esophagitis and Achalasia, in Current Treatment Options in Gastroenterology, 14(1), 51-60.
Symptoms Have Modest Accuracy in Detecting Endoscopic and Histologic Remission in Adults With Eosinophilic Esophagitis
Safroneeva Ekaterina, Straumann Alex, Coslovsky Michael, Zwahlen Marcel, Kuehni Claudia E., Panczak Radoslaw, Haas Nadine A., Alexander Jeffrey A., Dellon Evan S., Gonsalves Nirmala, Hirano Ikuo, Leung John, Bussmann Christian, Collins Margaret H., Newbury Robert O., De Petris Giovanni, Smyrk Thomas C., Woosley John T., Yan Pu, Yang Guang-Yu, Romero Yvonne, Katzka David A., Furuta Glenn T., Gupta Sandeep K., et al. (2016), Symptoms Have Modest Accuracy in Detecting Endoscopic and Histologic Remission in Adults With Eosinophilic Esophagitis, in Gastroenterology, 150(3), 581-590.e4.
Proton pump inhibitor-responsive oesophageal eosinophilia: an entity challenging current diagnostic criteria for eosinophilic oesophagitis
Molina-Infante Javier, Bredenoord Albert J, Cheng Edaire, Dellon Evan S, Furuta Glenn T, Gupta Sandeep K, Hirano Ikuo, Katzka David A, Moawad Fouad J, Rothenberg Marc E, Schoepfer Alain, Spechler Stuart J, Wen Ting, Straumann Alex, Lucendo Alfredo J (2016), Proton pump inhibitor-responsive oesophageal eosinophilia: an entity challenging current diagnostic criteria for eosinophilic oesophagitis, in Gut, 65(3), 524-531.
Comparison of different biopsy forceps models for tissue sampling in eosinophilic esophagitis
Bussmann Christian (2016), Comparison of different biopsy forceps models for tissue sampling in eosinophilic esophagitis, in Endoscopy, 1069.
Escalating incidence of eosinophilic esophagitis in Canton of Vaud, Switzerland, 1993-2013: a population-based study
Giriens B., Yan P., Safroneeva E., Zwahlen M., Reinhard A., Nydegger A., Vavricka S., Sempoux C., Straumann A., Schoepfer A. M. (2015), Escalating incidence of eosinophilic esophagitis in Canton of Vaud, Switzerland, 1993-2013: a population-based study, in Allergy, 70(12), 1633-1639.
Eosinophilic oesophagitis: relationship of quality of life with clinical, endoscopic and histological activity
Safroneeva E., Coslovsky M., Kuehni C. E., Zwahlen M., Haas N. A., Panczak R., Taft T. H., Hirano I., Dellon E. S., Gonsalves N., Leung J., Bussmann C., Woosley J. T., Yan P., Romero Y., Furuta G. T., Gupta S. K., Aceves S. S., Chehade M., Straumann A., Schoepfer A. M. (2015), Eosinophilic oesophagitis: relationship of quality of life with clinical, endoscopic and histological activity, in Alimentary Pharmacology & Therapeutics, 42(8), 1000-1010.
Diagnostic approach to eosinophilic oesophagitis: Pearls and pitfalls
Schoepfer Alain (2015), Diagnostic approach to eosinophilic oesophagitis: Pearls and pitfalls, in Best Practice & Research Clinical Gastroenterology, 29(5), 783-792.

Collaboration

Group / person Country
Types of collaboration
The International Gastrointestinal Eosinophil Researchers (TIGERS), Prof. G. Furuta United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Clinical Trial Unit Institute of Social and Preventive Medicine of University of Bern, Dr. S. Trelle Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
Psychiatric University Hospital Basel, MSc K. Meier Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Northwestern University of Chicago, IL, Prof. I. Hirano United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Industry/business/other use-inspired collaboration
Swiss IBD Cohort Study Group (SIBDCS), Prof. G. Rogler Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
Institute of Social and Preventive Medicine, University of Bern, Prof. M. Zwahlen Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Digestive Disease Week Talk given at a conference Natural history of eosinophilic esophagitis 04.06.2018 Washington, United States of America Schoepfer Alain; Coslovsky Michael; Safroneeva Ekaterina;
Digestive Disease Week, Washington Poster Treatment preferences of adult eosinophilic esophagitis patients 02.06.2018 Washington, United States of America Schoepfer Alain;
Digestive Disease Week Poster Short-and long-term therapeutic goals of adult patients with eosinophilic esophagitis. 02.06.2018 Washington, United States of America Safroneeva Ekaterina;
European Association of Allergy and Clinical Immunology (EAACI) Talk given at a conference Targeted elimination diet performs better than an empiric 6-food elimination diet. 29.05.2018 Munich, Germany Schoepfer Alain;
Europan Association of Allergy and Clinical Immunology (EAACI) Talk given at a conference Pharmacologic treatment of eosinophilic esophagitis and eosinophilic gastrointestinal disorders 26.05.2018 Munich, Germany Schoepfer Alain; Safroneeva Ekaterina; Coslovsky Michael;
Symposium of Swiss Society for Clinical Pharmacology (SSPT) Talk given at a conference Eosinophilic esophagitis: progress in pharmacotherapy. 25.01.2018 Bern, Switzerland Schoepfer Alain;
United European Gastroenterology Week Poster Eosinophilic Esophagitis: Relationship of Subepithelial Eosinophilic Inflammation With Epithelial Histology, Endoscopy, Blood Eosinophils, and Symptoms. 01.11.2017 Barcelona, Spain Safroneeva Ekaterina; Schoepfer Alain; Coslovsky Michael;
United European Gastroenterology Week Poster Treatment satisfaction of adult eosinophilic esophagitis patients. 01.11.2017 Barcelona, Spain Schoepfer Alain; Safroneeva Ekaterina; Coslovsky Michael;
FALK symposium 208 on medical and dietary treatment of eosinophilic esophagitis Talk given at a conference Meaningful readouts in EoE: symptoms, endoscopy, histology, distensibility: all for one or one for all 04.10.2017 Berlin , Germany Schoepfer Alain; Safroneeva Ekaterina;
FALK symposium 208 on medical and dietary treatment of eosinophilic esophagitis Talk given at a conference Pearls and pitfalls in the EoE histology 04.10.2017 Berlin, Germany Schoepfer Alain;
Swiss Congress of Gastroenterology and Hepatology Poster Cohort profile: the Swiss Eosinophilic Esophagitis Cohort Study (SEECS). 14.09.2017 Lausanne, Switzerland Coslovsky Michael; Safroneeva Ekaterina; Schoepfer Alain; Haas Nadine;
Swiss Congress of Gastroenterology and Hepatology Poster Systematic analysis of subepithelial eosinophil counts increases diagnostic yield in adults with eosinophilic esophagitis 14.09.2017 Interlaken, Switzerland Safroneeva Ekaterina; Haas Nadine; Schoepfer Alain; Coslovsky Michael;
Annual congress of Swiss Endoscopy Nurses Talk given at a conference Eosinophilic esophagitis. 14.09.2017 Lausanne, Switzerland Schoepfer Alain;
OESO World Conference Talk given at a conference Treatment endpoints in eosinophilic esophagitis 04.09.2017 Geneva, Switzerland Schoepfer Alain;
OESO World Conference Talk given at a conference Key points of the updated diagnostic guidelines in EoE 04.09.2017 Geneva , Switzerland Safroneeva Ekaterina; Schoepfer Alain;
Digestive Disease Week Poster Relationship between subepithelial eosinophilic inflammation, epithelial histology, endoscopic activity, and blood eosinophilia in adults patients with eosinophilic esophagitis. 09.05.2017 Chicago, United States of America Haas Nadine; Safroneeva Ekaterina; Schoepfer Alain; Coslovsky Michael;
Allergy School on Eosinophilic Esophagitis, organized by the European Academy of Allergy and Clinical Immunology (EAACI) Talk given at a conference Assessment of disease activity and definition of refractory EoE 18.03.2017 Vlaardingen, Netherlands Schoepfer Alain;
Allergy School on Eosinophilic Esophagitis, organized by the European Academy of Allergy and Clinical Immunology Talk given at a conference Diagnosis of Eosinophilic esophagitis 16.03.2017 Vlaardingen, Netherlands Schoepfer Alain;
annual congress of the Dutch Society of Allergology Talk given at a conference Diagnosis and treatment of eosinophilic esophagitis 15.03.2017 Vlaardingen, Netherlands Schoepfer Alain;
United European Gastroenterology Week Poster Influence of four different biopsy forceps models on quantity and quality of epithelial and subepithelial tissue sampling in eosinophilic esophagitis 18.10.2016 Vienna, Austria Safroneeva Ekaterina; Schoepfer Alain; Haas Nadine; Coslovsky Michael;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Tagung für EoE Patienten und Familien Talk 05.07.2017 Zurich, Switzerland Schoepfer Alain;


Communication with the public

Communication Title Media Place Year
Talks/events/exhibitions soirée d'information pour patients EoE et proches Western Switzerland 2015

Awards

Title Year
Faculty Prize of University of Lausanne for my master Student Audrey Simko for her Project "Eosinophilic Esophagitis: Relationship of Subepithelial Eosinophilic Inflammation With Epithelial Histology, Endoscopy, Blood Eosinophils, and Symptoms.", May 2018. 2018
Allergy Prize of the Swiss Society of Allergy and Immunology for the paper "Develpment and Validation of a symptom-based activity index for adults with Eosinophilic Esophagitis" (Gastroenterology. 2014 Dec;147(6):1255-669). Annual congress of the Swiss Society of Allergy and Immunology, Grindelwald, February 6th 2016. 2016

Associated projects

Number Title Start Funding scheme
148422 Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS) 01.04.2014 Cohort Studies Large
135665 Development, Validation and Evaluation of an Adult and Pediatric Eosinophilic Esophagitis Activity Index: A Prospective Multicenter Study 01.04.2011 Project funding (Div. I-III)
173197 Study of host-pathogen interactions to develop new Helicobacter pylori therapies and prevent adverse consequences of its eradication 01.09.2017 Project funding (Div. I-III)

Abstract

Background: Eosinophilic esophagitis (EoE) is a chronic, immune-mediated condition with a current prevalence of about 1 / 2,000 inhabitants in industrialized countries. Untreated eosinophil-predominant inflammation leads to esophageal remodeling with stricture formation and consecutive food bolus impactions with the inherent risks of esophageal perforation. The optimal long-term therapeutic strategy still needs to be defined. Until recently, no standardized instruments for measuring disease activity existed. Since EoE activity was assessed using different non-validated instruments, discrepancies between severity of symptoms and biologic measures have been described in some, but not in other studies. As such, endpoints for clinical trials and natural history studies could not be defined, and no specific therapies for EoE management have been approved by regulatory authorities in United States and Europe. Furthermore, different stakeholders do not come to an agreement on the therapeutic endpoints to be assessed in clinical trials and observational studies. Under the leadership of the applicants, the international EoE Activity Index (EEsAI) study group developed and validated instruments (questionnaires) that determine EoE symptom severity, quality of life, endoscopic and histologic activity.Objectives: We intend to take full advantage of our expertise in EoE activity assessment to address the following aims in three inter-related projects:Project I: We will identify endpoints (symptom severity, quality of life, endoscopic and histologic activity), which physicians and patients consider relevant for use in clinical trials and observational studies.Project II: We will define cut-off values of the EEsAI instruments scores for categorical disease activity (remission, mild, moderate, and severe disease). Using these definitions, we will examine the relationship between EoE symptom severity, quality of life, endoscopic and histologic activity in adult EoE patients.Project III: We will compare the efficacy of continuous and episodic treatment with oral viscous suspension of budesonide in maintaining clinical remission over a 54-week period in a proof of concept study.Methods: For project I, we will convene an inter-disciplinary working group composed of physicians with EoE expertise, representatives of regulatory authorities and industry. Delphi rounds will be conducted to achieve consensus on the selection of endpoints for clinical trials. The preliminary results will be shared with patients, and their input will be gained using surveys and focus group interviews. This input will be integrated into the final recommendations. In project II, we will define cut-off values of EEsAI scores for categorical disease activity states and examine the relationship between patient-reported outcome measures (symptoms, quality of life) and physician-reported biologic measures (endoscopic and histologic activity) in 250 prospectively included adult EoE patients. The strength of associations will be examined using the Spearman rank correlation coefficient.In project III, we will conduct a randomized, single-blind, non-inferiority trial (proof of concept study) comparing the efficacy of episodic and continuous treatment with oral viscous suspension of budesonide in maintaining clinical remission over a 54-week period. The primary endpoint will be the symptom score. Secondary endpoints will be quality of life score and stricture formation. A margin of 5 will be defined for non-inferiority of the episodic compared to continuous treatment. A total of 80 patients (40 per treatment arm) will be recruited. Analysis will be by intention to treat. The selected endpoints and definitions of categorical disease activity states from project 1 and 2, respectively, will be used to interpret the results.Expected results and importance: The definition of therapeutic endpoints will undoubtedly facilitate the development of much-awaited therapies for EoE management. Furthermore, this project will add new and important evidence from a well-characterized cohort of EoE patients on the relationship between patient reported-outcomes and biologic measures of EoE activity. The results of the randomized trial will be useful in optimizing long-term pharmacological treatment strategies.
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